Why smoking is an LGBT & HIV health issue

Most of you, I’m sure, have seen the latest graphic Department of Health advert to promote giving up smoking showing a cancerous growth appearing on a smoker’s fingers. Sticks in the mind doesn’t it? Whether you think it’s uncompromising and necessary or controversial and farfetched one thing’s for certain it shows that getting people to quit smoking is as necessary as ever, even in spite of falling rates in the UK. This is nowhere more important than within the (diverse and overlapping) LGBTQ and HIV positive communities.

Smoking rates amongst LGBTQ community are higher than the general population. A recent Canadian study estimates that while smoking prevalence nationally is around 17%, amongst the LGBTQ community it is almost double this at 36%. The reasons for this include social stress of being LGBT, discrimination and the image of smoking as fashionable on the gay scene (even after smoking has been outlawed in public places). Within the HIV positive community smoking rates are much higher than this. An American study showed that a massive 85% of HIV positive individuals have a history of smoking . Amongst LGBT individuals that are HIV positive smoking rates are likely to be even higher again, although official stats are hard to come by. The reasons for higher smoking rates amongst individuals that are HIV positive are (on the surface, at least) similar to reasons for elevated levels amongst the LGBT community: social stress and discrimination being two key factors.

Smoking and Prognosis for HIV community
Given up smoking is single most positive step HIV positive person can take to increase their life expectancy. Smoking increases disease burden and reduces quality of life. In particular, it increases the risk of opportunistic infections such as pneumonia, COPD (chronic obstructive pulmonary disease) and oral thrush. Mortality rates are 53% higher for HIV positive female smokers than their non-smoking counterparts. Research shows that not only does smoking increase the risk of illness linked to HIV, but also that smoking might have a bigger impact on the prognosis of HIV positive patients than HIV related factors . Whichever way you look at it, reducing smoking rates is a big challenge for those working in HIV health issues and health in the LGBT community.

Although general smoking cessation programmes might be useful for those who identify as LGBT and those that are HIV positive, research shows that specifically tailored ones are much more likely to be effective. They can target otherwise overlooked reasons for smoking, for example homophobia and stigmatisation and specific risks associated with not stopping smoking relevant to these particular groups, for example, opportunistic infections. One successful example (at least in terms of visibility) from the US is the CRUSH campaign, which is currently using the following posters to reduce smoking amongst the American LGBT community

US CRUSH LGBT Anti-smoking campaign posters

London LGBT focused smoking cessation programmes
In London there are also smoking cessation programmes working with the LGBT community specifically, but unfortunately there don’t seem to be any targeted at positive folk just yet. The following programmes work with the LGBT community and are open to those who are HIV positive and HIV negative:Metro Centre – Smoking cessation programme specifically for the LGBT community
anders@metrocentreonline.org

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